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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:j/kA/l�- __t�
Footing Susp. Ceiling Sprink, Rough-in Appr/Sdwlk
Foundation Fibg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Tup Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -BI
Plbg. Underfloor main`' Framing QTumb.
Alarm Water Line Insulation L �Mech.�
Underilr. Insu.. Shear Wall Gyp. Bd. ;(.
-Elect.
Date Requested:`- %�� Tim'a
M _PM
Address:—
Builder Permit ST C-'4/
-�•3�e THE FOLLOWING CORRECTIONS ARE REQUIRED:
z.o- CG
tr i ,AI
_ L l �.
In pectora^_
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
InsfzeTlon NOTICa �
Citi of Tigard Building Department
13125 BW Hall Blvd. Tigard, piygnn 97423
II
Inspection Line (Rec-O-Phone�j 639-1175 Business Phones 6427'1
IInspection:
rooting Plbg. Underslab Mach. Rough-in APP r/Sdwlk
round. Plbg. Top Out
Can Line FINAL:
Post/Beam Struct. San. Sewer framing -Bldg.
Post/SGAU, Mach. Rain Drain Insulation
-Plumb.
4-9. Underfloor Nater Line .> �-"��
-Mach.
Date Requested: /a 9 _Tiara:
AM PN
Address:_ rm
:
Builders--Le,7 ')p
THE 7--!-U XNO CORRECTIONS ARE REQUIRED: ---
Inspector
APPROVED Date:
- DI,SArpROVED --- APPROVED SUB.TECT TD AAOVR
Call For Reinep.
INSPECTION NOTA
Cit? of Tigard Building Department
13125 Bw Ball Bled. Tigard, Oregon 97223
Inspection Line (Roc-O-Phone)s 639-1175 Business Phon : 63 1
Inspections Ii
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk 1
Found. Plbg. Top out Gas Line FINAL: 111
Post/Beam Struct. Ran. Bower Framing -Bldg.
Post/Beam Vech. Rain Drain ��-��
�ue81iL1RII-� -Plumb.
Plbp. Underfloor Nater Line Gyp. ad. -Het.l.
Date Requested: S /f
��= AH PM
Address e
Builder.
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors �._-
Date
-n,&PROVED _4 DISAPPROVED APPROVED 811R"CT TO A
:��
` _Call For Reinap.
jNSPEL'YION NOTICE
City of Tigard Building Departaeet
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Ree-O-Phone): 639-4175 Hu' .kness Phone: 6 vi
lnspectiont
T«.ting Plbg. UnderalabMac Rough-+n Appr/Sdwlk
Tovnd. Plbg. Top Out Cas Line PINALt
r
Pr/t/Beam Struct. Sen. Sewer Eamin -Bldg.
Post/Ream Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach
Date Requestedt � _n Timet AM - PM
Addreast � �u� Permit
THE FOLL0WINC CORRECTIONS ARE REQUTREfJt
i
Inspectors 19 L_ __,.�^___�_.�_ uatetIrl
_APPROVED _^ — DISAePRO'JED APPROVED SGBJECT TO ABOVE
i For Reinap.
INSPRCTION NOTIQi
City of Tigard BUllding Department
1312S SM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rwc-O-Phone)c 639-4175 Bum iness Phone: 639-4171
Inspoctions
Footing lbg. Undorslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Can Line FINAL:
Post:/Beam Struct. Ban. Bower Framing -Bldg.
+ ' Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Mater Line Gyp. ad. -Hoch.
Date Requestod: PH
Addreas: 613'7.-;L-
Builders
?Pr,rmit 1t�_� '7
Builder:
ti —
TNR FOLLOWING CORRECTIONS ARE REQUIRED:
I
d
i
Inspector /--/ Date
\� _APPWATD --- DISAPPROVED APPROVED BURJEC4 TO ABOVE
—_Call For Reinap.
CITY OF TIGARD 4
COMMUNITY DEVELOPMENT DEPARTWAT MASTER PERM11-
1Z125 3W Hall Blvd.Tigard,Oregon 97223.8199 (503)820 4171 PERMIT #. . . . . . . : MST94-0392
DATE ISSUED: 10/13/94
PARCEL: ."_S 102AB-00209
Sl ADDRESS. . . : 09475 SW COMMERCIAL ST
SU )ISION. . . . : MARIELL ZONING: R-4. 5
BLL_K. . . . . . . . . . . LOT. . . . . . . . . . . . . ..9
--.----___.______________.-_-_------ BUILDING -------------------------------------- -
REISSUE:
----------______.__---__-______________REISSUE: DWELLING UNI'TS: 1 BASEMENT. . . . . . . . :0 sf
CLASS OF WORK. .-ALT BEDRMS:O BATHS:O GARAGE. . . . . . . . . . :0 sf
TYPE OF USE. . . :SF FLOOR AREAS--- --------- REQUIRED SETBACKS----------
TYPE OF CONST. :5N FIRST. . . . :0 s LEFT. . s0 ft RIGHT. :O ft
OCCUPANCY GRP. :R3 SF-COND. . . :O sf FRONT. :O ft REAR. . :O ft
STORIES. . . . . . . :0 FINBSMENT:O sf
HE I GHT. . . . . . . . : 0 ft 'TOTAL------- --a 0 sf SMOKE DETECTORS. :
FLOUR LOAD. . . . :40 psf VALUE. . . . . t ! 4500 PARKING SPACES. . :O
Remmrksa REMODLE
--------------------------------- PLUMBING --_---..--__-_-_---,__________--____----
!3INKS. . . . . . . . . . ..0 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . 10
LAVATORIES. . . . . : 1 WATER HEATERS. . . :0 TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . : 1 LAUNDRY TRNYS. . . : 1 CATCH BASINS. . . . . . . :0
WATER CLOSETS— al SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . sO
DISHWASHERS. . . . :0 WATER LINE. (ft ) . :0 OTHER FIXTURES. . . . . :0
GARBAGE DISP. . . :0 RAIN DRAIN (ft ) . :O
WASHING MACH. . . : 1 SF RAIN DRAINS. . :O
----------------- MECHANICAL _____.._._-.....__.-_.__.. __....__-.._.---.•---_.__.____.__ FEES
FUEL TYPES------•-------- UNIT HTRS. . -0 type amount by date rce-pt
/ELE/ / / VENTS , . . . :0 BPRT f 50. 50 KS 10/13/94 --
MAX INPUT:O BILI VENT FANS. . : 1 8PLC $ 32. 63 KS 10/12/94 94--257753
FURN ( 100K . . :0 HOODS. . . . . . :0 BSPC $ 2. 53 KS 10/13/94 -
FURN ) =100K . . a0 WOODSTOVES. :O MPRT $ 25. 00 KS 10/13/94 -
FLOOR FURN. . . . s O CLO DRYER. : 1 MSPC $ 1. 25 KS 10/13/94 -
BOIL./CMP ( 3HP:0 OTHER UNI fS:O PPRT $ 45. 00 KS 10 '13/94 -
GAS OUTLETS:O PSPC f 2. 25 KS 10/13/9•+
Owner: --_-__---__.____-------------------_.--
DENNIS TROUTMAN
9475 SW COMMERICAL ST
T I GARD OR 97223
Phone #: 664-2324
Contractor: -__.____________--_----___.__-•_--
OWNER
Phone #:
Re-9
$ 159. 36 TOTAL
This perait is issued subject to the regul&tions cent. -ned in the -- - -- REOUIRED INSPECTIONS -----_
Tigard Municipal Code, State of Ore. Specialty Codes a;1d all oth�.r PLM/Underfloor Plumb Final
applicable laws. All Mork will be done in accordance rith approved Mechanical Insp Building Final
plans. This perait will expire if work is not started ~.'thin 188 Plumb Top Out
days of issuance, or if work is susd# for sore than 188 days. Framing Insp _
Insulation Insp
Permittee Signature : ; Gyp Board Insp
F?ain drain Insp
IssL1ed By Mechanical Final
CAll for- e ion - 639-.4175
(,A&
Al
• Residential BuilcLIgq Permit Ap Vcation x`7`3
City of Tiganl
13125 SW Hall Blvd.
Tigard, OR 917223
(503) 639-,4171
k4
Jobsite Address: C40/1.1
)'�;Or/P // Lot# 4fce tIse Only
Subdivision: � �
SFU Planck/Rec# 1S✓r r_—
Valuation: � � .�_ _
----- Permit#
Corner Lot? v IN
Reissue of
Flag Lot? Y N
Map & TL# -;45 / 42A � 'j
Owner: � (��1�S � ►��1 uAWprova:s Requfra*J
Address: � ._I.GJ'YLY��R P'anning --
--- -11 �_ Engineering
Phone: �!=L � _ (� Other
Contractor: Item3 Regglred
Address — — Subcontractors _
--_---^_—`-- --_—__ Truss Details
Phone: ——--- - --- ---— Other
Contractor's License #
(affeco copy of current Oregon license)
Contact Name & Phone:
Subcontractors: ArchEtect/Englneer:
Plumbing: �__-- --___--- Address:
Mechanical: _--
(attach copy of cunent OR Contractor's License)
Phone:
JOB DESCRIPTION:
Applicant Signature & Phonnenumbe-
Received bye `-uQ — Date Received:
POWOPMC OMDE JIBE 9APF
Permit* Account Description Amount Amt. Pd. Bal. Due
ht sfr(q-o 3 f Z,, Bldg. Permit (BUILD)
Plumb. Permit (PLUMB) � �
Mach. Permit (MFc l) ✓-
State Tax (TAX) o 3
Bldg: ? s ✓
Plumb: oZ•Z
Mach: I t +
Plan Check (PLANCK) '—
Bldg: 2,b'3
Plumb:
Mach:
i
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parka Dev Charge (PKSDC)
Storm Drainage Chg (SDSDC) _
Residential TIF (TIF-R)
Mass Transit. TIF (TIF-MT)
Commercial TiF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS) _
Office TIF (TIF-0)
Nater duality (WOUAL)
Water Quantity (WQUANT) _
Fire District (FIRE)
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/LISA (ERFLAN)
Erosion Planck/COT (EROSN)
TOIALS: - 5' 3 -32,L3 ClILS
,�
PLAN CHECK FEES LIST -
PLAN CHEXX PERMIT #/Y1 5 y o J Z. DATR
JOBAADRESS
SUBDIVISION /'j v ,-(/ IAT # !7 LAND USE
VALUALATION i 0,' SETBRACT-7yi
O-NTREAR LEFT RIGHT
OIORK CLASS U r HEIGHT TOTAL AREA
USE TYPE F FLOOR LOAD 1ST
CONST TYPE S )`I HEAT TYPE 4 .P 2ND
OCLUP GROUP - DWELL/UNITS� 3RD
OCCUP/Lpo # BED ROOMS BASEMENT
# STORIES # BATHS GARAGE '
Ir' LNTT # DESCRIPTION AMOUNT ,AMOUNT PD BAL T)UB
BUILD PERMIT FEW S
PLUMB PERMIT FEES �-
NECK PERMIT FESS �
STATE BUILD. TAX(5%) —
BUILDING •> 3
PLUMBING z
MECHIANICAL__j 5
PLAN CHECr; FEES 3z i .;
BUILDIN4
PLUMB ING_�
MECHINICAL� _
SEWER CONNECTION
SEWER INSPECTION
STREET SYSTEM DEV —�—
STORM DRAINAGE SYS
PARKS SYSTEM DEV
EROSION PERMIT
EROSION PLAN USA
ERSOION PLAN COT —
TOTAL 1'3 _IaS. 53
City Of Tigard PlaricWRec. #
13125 SW Hail Blvd.
Tiaard. OR 512.23 k. PLUMBING PERMIT APPLICATION
MECHANICAL PERMIT MINIMI JP $25.00 PERMIT FEE+ST. SURCHARGE
APPLICATION
Nate►SMeale FartelF� Ressidetecef OnM
Table 3A Mecpesreical Cods OTY PRICE AMT
�- ---- ❑ 1 BATH HOUSE$140.00 ❑ 2 BASH HOUSF$195.00
1) Permit Fes -0- -0- 10.00 ❑ 3 BATH HOUSE!S225.00
- Fee hvJu les sr pM+nbkyi foftres in the dweWM and the hat 100 text
2) SLpplernentaf Pwm# 3.00 _ of water service, sanRsewer and sewand stome sewer. See fees bebw.
-
-- - FU(lUr65 OTY PRiC1E AWr
1) Intl.deny R vents 6.00 Sink _- Y 900
soca + Lavatory 9.00
2) iscL ducts A wrek --- - 750 --- Tub or Tub/Shower Comb. ' 9.00
�wnef Shower Only 9.00 -
3) ked.ve W 6.00 - - 9.00
WSW Cbast
4) or icor moue d heater 6.00 Dishwasher _ 9.00
I m Gamey Disposal 9.00
5) Psi - 3.00_ was" mwhine / 4.00
riTrep:- Floor Drain 9.00
4) a v&q•absorpdore unit 600 ---_- --orWOON camp. f P•aer - Wsw Flealar _�- 9.00 _
7) in 3 HP she rp unit to LOOK BTU 6.00 --- LaursU y Room TrayWailer or 9.00 < -
-�� 9.00
�eP. pump,-x udrwt , -
®) 3-15 HP absorp uric to 500K BTU - 11.00 --- Outer =ie M (Spew 9.00 --
sr rx aneeep, pump.air Co. 9.00
9) 15'0 HP absarp unit.'S 1 mi BTU 1500 _ 9.00
or camp. Pump•ie.�- r -----
10) 30-50 HP abcorp unit 1-1 75 mi BTU 22-50 - 9.00 -
`"--1001W oro mp.ar oor�- - Sewer let 100' 3U.00
11) :PAS HP a 11 unit 1.75 mm BTU 37.50 Sewer-as.Addle 100• - 28.00
Air heiv&V 12) 10.000 CFM 4.50. Water service let 100 - 3U.00
-xr-Nkkkt Una WAK Service as Addk. 200• 25.00
13) 10.000 CTM• 7-M Storm 3 Rain Drain tet 100• - 30.00
14) ffmevaportems ts ax>fer 4.50 Stam 6 Pdn"gain AddIL 100' 23.00
Vero ton B5KRZIR 300 ti}' ° Mobi+ Homs Space 25.00
15) to a shale dud -
eer► sys�eii ink- Back Flow Prevention I
16) keckdd In apple"hermit 4.50
Device a Mti PoOutlom Device - - 9.00
'-by Any Trap or Wasts Mot
17) mecfwdcri*Amst 4.50 Connedeed to a FkWm - 9.00 J
Corrinvari a v s C" Basks 9.00
16) type inc6nerabr 30.00 heap. of E�dst PkRnbUV 40.00ft --
es. .waterS/sdsly Requested InsPec6orq 40.Oikhr
19) heater.salt,eidfras eiryers,etc 4.50 '�. ' U Rain Drain. skVM fsmNy dweikq 3-1.00
20) Cees pipkq oma b four outlets 2.00 Res"en1W bw*fbw prevention --
devices 1 i.n10
21) Mons then 4-par ou6M.
'(Except reslda ir"bee Mfaw I
binknum Vies$2,&00 SUBTOTAL -5
'Mrtkeeean Fee SM00 SUBTOTAL l
5%SURCHARGE T ? 7 -
-
PLAN REVIEW 25%OF SUBTOTAL 576 SURCHARt3E-
TOTAL PLAN REVIEW 25%OF SUBTOTAL
TOTAL
Spw*J Conditions
Dale Issued_ by _
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CATY OF '11GARD Rk*.GkI1JT OF PAYMEN1 REUkIPT NU. %94-257i8b
CHECK AMUUNI z 126. 61-K�
NAME t T'ROU rMAN, VENNIS LASH AMOUNT t 0. 00
ADDRF-F,S s 9475 SW COMMERCIAL, PAYMENT DATE t 10/ 1 :3/94
SUBDIVISION
-rmARD, OREUON 9-1223-
oURFIGiE 0i; PAYMtW1 AMOUNT PAID PURPOSE OF PAYMENI AMOUNT PA 11)
OUILDING PERM .0. &li PLUMS I NQ flft 45. 00
NECHANICAL PE 25. 00 ST. AUILD PER 6. 03
AMOUNT PAII; 126. 53
Permit#:
Address:
Issued by: Date:
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS;01.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under DRS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2,and either box 3A or 3B:
M1. I own, reside in, or will reside in the completed structure.
L__.I 2. I understand that I must register as a construction cor_tractor if the structure is sold or offercd for sale
u before or upon completion.
a3A. My general contractor is
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
3B. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. if I change my mind and hire a general contractor, I will contract with a contractor wiw is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above Information Is correct and that 1 have read and do under-land the Information
Notice to Propert Owners about Construction Responsibilities on the reverse side,-if this form.
(Signature of permit applicant) (Date)
(White copy to issuing agency pernUr•ile,
pink copy to applicant)
Information Notice to Property Owners
About Construction Responsibilities
Nott.: This Information Notice to Property Owners about Construction Re:sponsibi,ities
u is deveiaped by the Construction Contractors Board in accordance with ORS 701.055(5).
If you are acting as your own c.ntractor to construct a new home or make a substantial improvement to ar existing structure,
you can prevent many problems by being aware of the following responsibilities and areas of concern.
EV OLOYER RESPONSIBIL�TIES:
If you hire persons not registered with the Construction Cont-actors Board to do labor in constructing or assisting in the
construction or improvement of a*esidential structure,you will,in most instances,be rut a to be an employer and the people
you hire will be employees As the employer,you must comply with the following:
Oregon's witl holding tr x law: As an employer,yeti must withhold income taxes from employee wages at the time employees
are paid. You pill be liable for the tax payments even if you don't actually withhold the tax from your employees. For more
information,call the Oregon Dept.of Revenue at 945-8091.
Unemployment insurance tax: As an employer,you are required to pay a tax for unemployment insurance purposes on the
wages of all employees. For more information,call the Oregon Employment Division at the Department of Human Resources
at 378-3524.
Workers'compensation Insurance: As an employer,you are subject to the Oregon Werkers'Compensation Law,and'nitrkt
obtain workers'compensation insurance for your employees. If you fail to obtain workers'compensation insurance,you may
be subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more information;
call the Workers'Compensation Division at the Department of Consumer and Business Services at 945-7888.
U.S.internal Revenue Service: As an emp• • er,you must withhold federal income tax from employees'wages. You will be
liablo for the tax payment even if you didn't actually withhold the tax. For more information,call the Internal Revenue Service
at 1.800-829-1040.
O TITER RESPONSIBILITIES AND AREAS OF CONCERN:
Code compliance: As the permit holder for this project,you are responsible for resolving any failure to meet code requirements
that may be brought to your attention through inspections.
Liability and property damage Insurances Contact your insurance agent to see if you have adequate insurance coverage for
accidents and omissions such as falling tools,paint overspray,water damage from pipe punctures,fire,or work that must he
re-done.
Time to supervise Employees: Make sure you have sufficient time to supervise your employees.
Expertise: Make sure you have the expertise to act as your own general contractor,tbcoordinate the work of rough-ih and finish
trades,and to notify building officials at the appropriate times so they can perform the required inspections.
If you havef additional questions,write or call the Construction.Contractors Board(PO Box 14140,Salem,OR 97309-50.52,
503/378-46-1 1). The Board is located at 700 Summer St.NE Suite 300, in Salem.
prop-own.pm4
1194
WlY OF HPA."LIPT" OF' PAYPILM [* CFJPI NO. 19-w i.t,)l 71.5."
(MELK MOUNT a 83
MML. a TROUTMAN9 DENNIG CASH AMC)UN 1 3 00
947"S SW COMMI-'R(*.,IAI. AVE PAYMFNT DAI F. a f 0/ 1 k,,V94
SUBU I V I ION
TIOARD, 97283—
''URPOSE, (IF PAYMEN1, "M(fliAl HAI[) 1JURPOSE OF PQYMENT AMOL041 PAIL)
'CK FE 32. 83
I 'IN
83